title: Lower incidence of emergence agitation in children after propofol anesthesia compared with sevoflurane: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Emergence agitation (EA) from general anesthesia has been reported as an adverse effect of sevoflurane in children. We describe a meta-analysis of randomized controlled trials that compared the incidence of EA between children who underwent sevoflurane anesthesia and those who underwent propofol anesthesia.
  
  
  METHODS
  A literature search was conducted to identify clinical trials that met our inclusion criteria. Prospective randomized trials comparing sevoflurane and propofol anesthesia in children less than 15 years of age were included in the meta-analysis. Data from each trial were combined using the random effects model to calculate pooled odds ratios (ORs) and their corresponding 95 % confidence intervals (CIs). The heterogeneity of data was assessed by Cochran's Q and I (2) tests. Sensitivity analysis was conducted for study quality, patient age, and type of surgical procedure.
  
  
  RESULTS
  The meta-analysis included 14 studies, in which 560 patients received sevoflurane and 548 received propofol. The pooled OR for EA was 0.25 with a 95 % CI of 0.16-0.39 (P = 0.000), which indicates that propofol anesthesia resulted in a lower incidence of EA. The heterogeneity of data was not statistically supported (P = 0.191). All sensitivity analyses strengthened the evidence for the lower incidence of EA with propofol.
  
  
  CONCLUSIONS
  Our meta-analysis demonstrated that EA in children is less likely to occur after propofol anesthesia compared with sevoflurane anesthesia.
authors.affiliation: Department of Anesthesiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan, canal_village0207@yahoo.co.jp.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kanaya
authors.forename: Norifumi
authors.initials: N
authors.lastname: Kuratani
authors.forename: Daizoh
authors.initials: D
authors.lastname: Satoh
authors.forename: Shin
authors.initials: S
authors.lastname: Kurosawa
mesh_terms: D000293:Adolescent; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects; D018685:Anesthetics, Inhalation / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D002648:Child; D006801:Humans; D015994:Incidence; D008738:Methyl Ethers / Q000009:adverse effects*; D015742:Propofol / Q000009:adverse effects*; D011595:Psychomotor Agitation / Q000453:epidemiology*; D016032:Randomized Controlled Trials as Topic; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol